Statins and fracture risk. A systematic review

摘要: Purpose To summarize current evidence on statin use and fracture risk to explore potential sources of heterogeneity among study results. Methods A computerized search was conducted MEDLINE, EMBASE, the Cochrane databases using keywords HMG-CoA reductase inhibitor, osteoporosis, fractures. A meta-analysis performed results studies identified. Results Statin associated with a 23% lower (OR = 0.77, 95%CI: 0.66–0.90). An effect statins found in case-control (OR = 0.62, 0.45–0.85, n = 6) cohort 0.59–1.00, n = 8) studies, but not post hoc analyses randomized trials (OR = 1.03, 0.91–1.16, n = 4). reduced for fractures hip (OR = 0.58, 0.46–0.74, n = 16), spine (OR = 0.65, 0.48–0.88, other sites 0.60–1.00, n = 7), both women (OR = 0.80, 0.66–0.96, n = 11) men 0.36–1.08, n = 3). Among observational that also evaluated lipid-lowering drugs, no these agents (OR = 0.96, 0.85–1.09, n = 10). The test significant versus no-use (p < 0.01). Meta-regression suggested design might partly account heterogeneity. There an indication publication bias by examining Begg's plot, although Egger's (p = 0.13). Conclusions Current does support preventing given (i) lack association trials, (ii) (iii) residual confounding, (iv) bias. Copyright © 2007 John Wiley & Sons, Ltd.